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Effect of long-term angiotensin-converting enzyme inhibition on vascular function in patients with chronic congestive

M Jeserich1, L Pape, H Just

  • 1Medizinische Klinik III, University of Freiburg, Germany.

Insights

Peripheral vasodilatory capacity is reduced in heart failure patients not taking aspirin. Angiotensin-converting enzyme inhibition can restore this capacity, suggesting a role for cyclooxygenase-dependent factors in vasoconstriction.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Peripheral vasodilatory capacity is often impaired in patients with chronic congestive heart failure.
  • Aspirin's effect on this impairment is not fully understood.

Purpose of the Study:

  • To investigate the role of aspirin and angiotensin-converting enzyme (ACE) inhibition on peripheral vasodilatory capacity in chronic congestive heart failure (CHF).
  • To determine if cyclooxygenase-dependent factors contribute to vasoconstriction in CHF.

Main Methods:

  • Comparing peripheral vasodilatory capacity in CHF patients treated with and without aspirin.
  • Assessing the effect of chronic ACE inhibition on peripheral vasodilatory capacity in CHF patients.

Main Results:

  • Peripheral vasodilatory capacity was impaired in CHF patients not taking aspirin but preserved in those taking aspirin.
  • Chronic ACE inhibition restored the decreased peripheral vasodilatory capacity in CHF patients.
  • Findings suggest locally acting cyclooxygenase-dependent factors contribute to peripheral vasoconstriction in CHF.

Conclusions:

  • Aspirin appears to preserve peripheral vasodilatory capacity in patients with chronic congestive heart failure.
  • Cyclooxygenase-dependent mechanisms play a role in the peripheral vasoconstriction observed in chronic congestive heart failure.
  • ACE inhibition can overcome the impaired vasodilation in these patients.

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